Unmet Needs in the Treatment of Anxiety Disorders

There are a number of unmet needs in the treatment of anxiety disorders including the need for more effective, rapidly acting, and better tolerated medications; early identification of nonresponse; effective treatments for refractory disorders; prevention of relapse; and promotion of resilience and long-lasting response. Rates of response to contemporary antidepressants and other anxiolytics are often less robust than might be hoped, and remission rates, which have until recently been infrequently measured, are even lower. A small number of mostly uncontrolled studies suggest a role for augmentation of initial therapy with a second modality in patients who do not fully remit to treatment. There also is a small but growing literature which suggests the use of novel anticonvulsants and atypical antipsychotics in the treatment of anxiety disorders should be further studied. However, a definitive place for these newer therapeutic strategies in the anxiety disorder treatment armamentarium awaits evidence from large, controlled studies.